Kornimate/medical-research-clean huggingface dataset:
chronic malnutrition and oral health status in children aged one to five years

Conditions: Malnutrition, Child

Summary: malnutrition is a public health problem that can exert a negative impact on the general and oral health of children. the aim of the present study was to evaluate the effect of chronic malnutrition on the oral health of children aged one to five years. an observational, analytical, cross-sectional study was conducted at the nutritional recovery center and involved 82 children between 12 and 71 months of age. nutritional status was evaluated using anthropometric indicators and oral health status was measured using the dmft index. non-stimulated saliva was collected. flow rate and buffering capacity was then measured with the aid of a ph meter.

malnutrition is a public health problem that can exert a negative impact on the general and oral health of children. the aim of the present study was to evaluate the effect of chronic malnutrition on the oral health of children aged one to five years. an observational, analytical, cross-sectional study was conducted at the nutritional recovery center and involved 82 children between 12 and 71 months of age. nutritional status was evaluated using anthropometric indicators. the children were weighed on a previously calibrated electronic scale (capacity: 150 kg; precision: 100 g) barefoot and wearing light clothing in the presence of the mother or caregiver. height was determined using a non-flexible metric tape (maximum length: 2 m; precision: 0.1 cm). each measurement was made twice and the mean was used for the calculation height for age, weight for height and weight for age. the guidelines of the world health organization, were the reference for the evaluation of nutritional status. oral health status was measured using the dmft index. the criteria adopted for the determination of prevalence followed by guidelines of the oral health surveys - basic methods, 4th edition - described in the examiner's manual and annotator's manual produced by the coordination team of the brazil oral health project. non-stimulated saliva was collected and flow rate and buffering capacity was then measured with the aid of a ph meter. the salivary flow volume was calculated and expressed as ml/min. the following categories were considered in the analysis of salivary flow: \ 2.0 ml/min = high flow. the following categories were considered: ≥ 5.5 = very good buffering capacity; 5.4 to 5.0 = good buffering capacity; 4.9 to 4.5 = medium good buffering capacity; 4.4 to 4.0 = low buffering capacity; and ≤ 3.9 very low buffering capacity.

Eligibility criteria:
inclusion criteria: children aged one to five years enrolled at the center for educational and nutrition recovery. statement of informed consent signed by parents/guardians. clinical diagnosis of malnutrition. exclusion criteria: children aged one to five years not enrolled at the center for educational and nutrition recovery. children whose parents/guardians did not sign a statement of informed consent.

Keywords: dental caries saliva child
hearing impairment, strategies, and outcomes in emergency departments

Conditions: Hearing Loss; Emergency Service; Hospital Readmission

Summary: aim 1: establish the feasibility of screening for hearing loss in the ed aim 2: determine the acceptability of the screening procedure (among the ed population) aim 3: derive a preliminary estimate of the effect size of primary outcomes aim 4: identify the evidence that decision makers in veteran affair medical centers, ed and audiology services need to commit to this approach

the goal of this study is to test whether providing hearing assistance devices to older age hearing impaired patients in the ed setting will improve in-ed understanding and preparation for discharge. the proposed intervention, the hearing impairment, strategies and outcomes in va emergency departments (hearva-ed) will be conducted in the emergency departments of the manhattan and brooklyn vas of the new york harbor healthcare system and will recruit hearing impaired ed patients who are 60 years and older and have been admitted to the ed with a low acuity triage score indicating a high likelihood of discharge home. the investigators will identify hearing impairment by using the hearing handicap inventory for the elderly survey (hhie-s). the investigators will randomize consenting patients who fail the screening to either receipt of a simple hearing assistance device (a "pocketalkertm") during their ed stay or usual care. the investigators will test whether the provision of a pocketalkertm is feasible in this environment (by measuring the amount of device use), whether providing the device improves self-reported quality of hearing and understanding during the ed stay, and whether use of the device improves the quality of preparation for post-discharge care. if this randomized controlled trial demonstrates beneficial effects for in-ed use of a simple hearing assistance device for hearing impaired patients, this strategy can be disseminated throughout the va healthcare system.

Eligibility criteria:
inclusion criteria: * english or spanish speaking * emergency severity index criterion of 4 or 5 (low acuity) * hearing handicap impairment evaluation screen greater than or equal to 24 * capacity to consent to participate in research exclusion criteria: * inability to consent to participate in research * emergency severity index criterion of 1-3 (high acuity) * hearing handicap impairment evaluation screen less than 24 * inability to speak english or spanish

Keywords: emergency service hearing loss patient readmission communication
randomized, controlled trial of posterior c1-2 fusion versus bracing alone for treatment of type ii odontoid process fractures in the elderly

Conditions: Odontoid Fracture

Summary: this prospective study addresses one of the most controversial topics in the treatment of cervical spine trauma: the management of type ii odontoid process fractures in the elderly. it is the hypothesis that surgical treatment will result in improved functional outcome measures, neck pain and mortality rates as compared with nonsurgical management. furthermore, it is hypothesized that surgical treatment of odontoid process fractures will limit hospital re-admissions and development of medical complications secondary to prolonged immobilization in a cervical orthosis and delayed surgery related to late fracture displacement, which are often associated with non-operative care. additionally, data from this study will be useful in identifying patient-specific predictors of improved outcome which can be used to optimize treatment algorithms and more effectively counsel patients who sustain these injuries.


Eligibility criteria:
inclusion criteria: patients to be considered for trial enrollment will include those: 1. ages 65 and older; 2. presenting with type ii odontoid fracture confirmed by ct scan to one of the study centers; 3. deemed appropriate by the attending surgeon involved for c1-2 posterior cervical fusion procedure if surgical management were to be indicated 4. able to independently cooperate in the completion of all study consents, forms and documents. 5. able to speak, read and write english at an elementary school level exclusion criteria: patients to be excluded from trial enrolment include: 1. those with previously documented type ii odontoid fracture; 2. those with odontoid fracture related to malignancy or infection; 3. those with associated spinal cord injury 4. those with other cervical, thoracic or lumbar injuries requiring surgical intervention 5. those with aberrant/anomalous local anatomy which precludes posterior placement of c1/2 instrumentation
wide awake open carpal tunnel release with or without a tourniquet

Conditions: Carpal Tunnel Syndrome

Summary: the goal of this clinical trial is to compare open carpal tunnel release using local anesthesia with or without a tourniquet. the main questions it aims to answer are: 1. do the tourniquet cause more procedural pain? 2. does the use of tourniquet affect the outcome after the procedure? participants will be randomized to either local anesthesia with a tourniquet or local anesthesia with adrenaline, and undrgo standard open carpal tunnel release.


Eligibility criteria:
inclusion criteria: * primary idiopathic cts * age 18 or older * symptoms of classic or probable carpal tunnel syndrome according to katz hand diagram * no previous wide awake hand surgical procedures under local anesthesia * no planned concomitant procedures exclusion criteria: * recurrent carpal tunnel syndrome * vibration induced neuropathy * polyneuropathy * cognitive impairment * anxiety disorder * swedish language insufficiency * active substance abuse * allergy to local anesthesia or adrenaline * patient refusal to participate
effects of proteins in patients with cirrhosis and prior hepatic encephalopathy

Conditions: Hepatic Encephalopathy

Summary: the purpose of this study is to compare a normal-protein diet containing branched-chain amino acids to a low-protein diet in patients with non-terminal cirrhosis (meld \< 25) who have developed an episode of hepatic encephalopathy within two months prior to inclusion.

hepatic encephalopathy is a major complication of cirrhosis associated with poor prognosis and poor quality of life. appearance of he occurs in the setting of precipitating factors that increase plasma ammonia. the gastrointestinal tract is the primary source of ammonia, which is produced by enterocytes from glutamine and by colonic bacterial catabolism of nitrogenous sources, such as ingested proteins. this is the rationale for proposing low-protein diet as strategy to reduce ammonia production and as standard diet in patients with cirrhosis and hepatic encephalopathy. however, low-protein diet could cause wasting muscle and predispose to recurrence of hepatic encephalopathy, since muscle is an important site for extrahepatic ammonia removal. branched-chain amino acids have shown beneficial effects on mental state of patients with chronic hepatic encephalopathy. the possible mechanism of action may be improvement of nutritional status through induction of protein synthesis. however, role of branched-chain amino acids in treatment and prevention of acute hepatic encephalopathy is not established. administration of a normal-protein diet containing oral branched-chain amino acids may reduce recurrence of hepatic encephalopathy as compared to a low-protein diet.

Eligibility criteria:
inclusion criteria: * cirrhosis of the liver. * recovery from an episode of hepatic encephalopathy within two months prior to inclusion. * compliance with a standard diet during two weeks prior to inclusion. exclusion criteria: * end-stage cirrhosis (meld score \> 25). * marked cognitive disorder (mini-mental test \< 27). * non-treatable hepatocarcinoma in accordance with milan criteria. * comorbid conditions with a life expectancy less than 6 months. * neurological conditions that difficult assessment of treatment of hepatic encephalopathy (dementia, encephalitis, severe depression). * diseases requiring administration of a specific diet (malabsorption, chronic diarrhea, chronic pancreatic insufficiency, severe obesity). * no acceptation of written consent.

Keywords: hepatic encephalopathy cirrhosis proteins of the diet branched-chain amino acids
effect of reduced vasopressors on mortality in ecmo-supported cardiogenic shock patients

Conditions: Cardiogenic Shock; Extracorporeal Membrane Oxygenation; Vasopressors; Hemodynamic Management; Critical Care; Heart Failure

Summary: the goal of this observational study is to learn about the association between vasopressor exposure levels and outcomes in adults with cardiogenic shock receiving va-ecmo. the main question it aims to answer is: does reduced exposure to vasopressors lower the 30-day mortality in patients with cardiogenic shock when receiving ecmo support? participants who are receiving ecmo support for cardiogenic shock as part of their regular medical care will have their data collected, including information about their vasopressor use and mortality outcomes, over the course of the study.

the study will enroll 534 patients from multiple centers who require va-ecmo for cardiogenic shock. patients will be stratified into two groups based on their average vasoactive-inotropic score (vis) from 12 hours post-ecmo initiation to weaning: a high-dose group (vis \>10) and a low-dose group (vis ≤10). the primary outcome is 30-day all-cause mortality. secondary outcomes include hospital survival rate, duration of mechanical ventilation, icu and hospital length of stay, and ecmo-related complications. hemodynamic parameters and laboratory biomarkers will be monitored. the study aims to identify optimal hemodynamic management strategies, including ecmo flow rates, blood pressure targets, and vasopressor dosing, to improve patient outcomes.

Eligibility criteria:
inclusion criteria: * adults (≥18 years) with cardiogenic shock requiring va-ecmo support. * first-time ecmo initiation. * venoarterial ecmo (va-ecmo) as the initial mode. exclusion criteria: * age \<18 years. * severe pulmonary hypertension. * vasopressor use for non-shock indications (e.g., bleeding, post-cardiopulmonary bypass vasoplegia). * severe missing data.
exercise program in women with metabolic syndrome

Conditions: Metabolic Syndrome

Summary: the purpose of this study is to test whether a supervised mixed aerobic and strength training (mast) program is effective in improving overall physical fitness and blood flow in the brain and lowering risk factors of coronary artery disease (cad) in women with metabolic syndrome.

metabolic syndrome is a cluster of conditions and disorders that increase the risk for coronary artery disease (cad) and strokes. sedentary lifestyle is one of the risk factors, which decrease overall physical fitness and together with aging may lead to decrease in physical functioning in everyday life as well as changes in blood flow in the brain and cognitive functions. regular physical activity is associated with a reduced risk of cardiovascular disease. it may also improve blood flow velocity and cognitive functions. physical activity should be as effective as possible, but also as safe as possible. supervised mixed aerobic and strength training (mast) program for 4 months enables to individualize the intensity of aerobic exercise based on measured maximal exercise capacity. throughout each training session heart rate will be monitored with a new real time wireless ecg system.

Eligibility criteria:
inclusion criteria: * post-menopausal women * age 50 or over * diagnosed metabolic syndrome exclusion criteria: * any unstable or acute medical condition that the study physician deem unsafe for participation * positive stress test for cad or other ischemic conditions * myocardial infarction or major surgery within 6 months * history of a clinically documented stroke * clinical dementia (by history) or inability to follow details of the protocol * carotid stenosis \> 50% by medical history * insulin dependent diabetes mellitus (also type ii, if using insulin) or history of severe hypoglycemic episodes within 6 months requiring hospitalization * liver or renal failure or transplant * severe blood pressure elevation (systolic bp \> 180 and/or diastolic bp \> 110 mm hg) * anemia (hb \< 10) * seizure disorders * current recreational drug or alcohol abuse * bmi \> 45, but body weight under 280 lbs * inability to obtain permission for participation from the primary care physician * clinically significant and movement limiting hip, knee and/or back disorders or injury, and rheumatoid arthritis * transcranial doppler (tcd) exclusion criteria - poor insonation window and tcd signal
effectiveness of auto-adjusted continuous positive airway pressure for long-term treatment of sleep apnea

Conditions: Sleep Apnea, Obstructive

Summary: hypothesis: computer controlled continuous positive airway pressure (autocpap) is equally effective in improving obstructive sleep apnea syndrome symptoms, breathing disturbances, objective vigilance, and it is cost-effective compared to conventional fixed continuous positive airway pressure.

1. to investigate whether computer controlled continuous positive airway pressure (autocpap) improves subjective sleepiness, quality of life, objective vigilance, and nocturnal respiration to a similar degree as conventional fixed continuous positive airway pressure in the initial phase of treatment and over the subsequent 2 years during home therapy 2. to investigate the cost of autocpap compared to fixed cpap therapy

Eligibility criteria:
inclusion criteria: * excessive sleepiness, and epworth sleepiness score \> or = 8 * apnea- hypopnea-index (ahi) \> or = 10/hour * age 18-75 exclusion criteria: * psychophysiological incapacity to perform questionnaires * other sleep disorders * psychiatric disease requiring treatment * previous cpap therapy * previous uvulopalatopharyngoplasty * chronic nasal obstruction that required treatment for more than 1 month * cancer * copd, with fev1 \< 50% predicted * symptomatic cardiovascular disease requiring treatment defined as congestive heart failure \> nyha ii * previous stroke with neurological residuum * cheyne-stokes respiration * chronic pain syndromes, fibromyalgia * drug or alcohol addiction

Keywords: randomized controlled double blind effectiveness auto cpap treatment sleep apnea
the effectiveness of dry needling and classic physiotherapy programs in the patients suffering from chronic low back pain caused by lumbar disc hernia

Conditions: Metabolic Syndrome; Physical Activity; Quality of Life

Summary: aim: this study was planned for comparing physical activity levels, nutrition quality and quality of life of the individuals that are diagnosed with and without metabolic syndrome (mets) and that live in the turkish republic of northern cyprus (trnc). method: 1200 individuals in total, in which (n: 660) individuals diagnosed with mets and (n:660) individuals not diagnosed with mets, participated in this study. socio-demographic characteristics of the individuals that participated the study were registered with a survey form. the long form of the international physical activity questionnaire was used for determining physical activity levels of the individuals; whereas total numbers of daily steps were carried out with pedometer. the 14-item mediterranean diet adherence screener (medas) was used for the assessment of dietary habits, nottingham health profile (nhp) was used for the assessment of health-related qualities of life of individuals and beck depression inventory (bdi) was used for the assessment of depression. in addition, biochemical analysis and anthropometric measurements of individuals were also taken.


Eligibility criteria:
inclusion criteria: * patients among the ages of 35-70, * suffering from lbp for at least 3 months, * diagnosed with ldh having at least 1 active trigger point that can be cooperated . exclusion criteria: * those with ldh that show neurological symptom, * having any orthopaedic problem at lower extremity and lower back region, * having sacroiliac joint problem, diagnosed with lumbar spondylolisthesis, * having any neurologic, rheumatic, oncologic problem, * who received any physiotherapy program at least 6 months before, patients having any corticosteroid treatment or oral medication * those having needle phobia were not included in the trial.

Keywords: nutrition public health
identification of new biomarkers for patients with cholangiocarcinoma and gallbladder cancer

Conditions: Biliary Tract Cancer; Cholangiocarcinoma; Gallbladder Cancer

Summary: no validated biomarkers exist that can identify patients with biliary tract cancer at an early stage or predict treatment outcomes. the objective of the present study is to find diagnostic, prognostic and predictive biomarkers.

biliary tract cancer (btc) is a heterogeneous disease and includes both gallbladder cancer and cholangiocarcinoma. combined btc is the fifth most common gastrointestinal cancer. the prognosis is poor with a median overall survival of less than a year and estimated 5-year survival of about 20 % for all stages. the poor survival is related to aggressive malign nature, late diagnosis, and limited treatment options. today, only ca 19-9 is used in routine practice but its use as a prognostic or diagnostic biomarker is very limited. the objective of the present study is to find diagnostic, prognostic, and predictive biomarkers, which can be used to 1) diagnose btc early in the disease course with high specificity and sensitivity, 2) improve prognostication, or 3) predict and monitor treatment effectiveness and tolerability for the individual patient. choca is an observational and translational open cohort study with a prospective collection of biological materials (blood samples and tissue) and clinical data in patients with btc receiving standard or protocolized treatment. blood samples (i.e. serum, edta plasma and buffy coat, and blood in paxgenerna tubes) are collected from all patients before operation or start of chemotherapy and during treatment with blood sampling before the 2nd cycle of chemotherapy and longitudinally at the time of follow-up ct scan (about every 3 months) until disease progression. tissue removed during routine diagnostic procedures or treatment will be requisitioned. the patients are followed until death. the following data are collected: demographics, disease characteristics, comorbidities and lifestyle factors, routine blood tests (i.e. hematology, creatinine, liver enzymes, bilirubin, carbohydrate antigen 19-9, c-reactive protein); type of operation; types of chemotherapy, reason for termination of therapy; date of disease recurrence in operated patients; date of disease progression for each line of chemotherapy; and date of death. biomarker analyses will include a range of molecules with different characteristics such as dna, single nucleotide polymorphism (snps), rna, microrna, proteins, proteoglycans, and metabolites. controls will be included from other studies in order to identify potential diagnostic biomarkers,. controls include patients with other diseases or healthy subjects. biomarkers will be analyzed using appropriate methods and statistical analysis following remark guidelines.

Eligibility criteria:
inclusion criteria: * histological or cytological diagnosis of btc * patients referred for treatment of btc * signed informed consent exclusion criteria: * none

Keywords: prospective observational open cohort study biomarkers diagnostics prognostics prediction of treatment efficacy
the kabeho study: kigali antiretroviral and breastfeeding assessment for the elimination of hiv

Conditions: Mother-to-child HIV Transmission

Summary: the study design includes an observational prospective cohort of hiv-positive pregnant/postpartum women and their infants enrolled during antenatal clinics (or immediately postpartum) from prevention of mother-to-child transmission (pmtct) programs and followed until the infants reach the age of 18 - 24 months and semi-structure interviews with a sub-set of these women. a second study component involves semi-structured interviews with health care workers (hcw) involved in the pmtct programs and yearly facility surveys at the selected study facilities.


Eligibility criteria:
inclusion criteria: * documented hiv infection * pregnant, in the last trimester of pregnancy or within two weeks post-delivery. * participation in the pmtct program during antenatal care at one of the study sites * planning on remaining in the kigali area after delivery * able and willing to give informed consent for study participation for herself and her infant(s). if a pregnant woman is less than 18 years of age and still living with her parents, informed consent will also be required from one of her parents exclusion criteria: * women not willing to provide informed consent to participate

Keywords: hiv pmtct antenatal care